Rural patients more likely to die from cancer than those in cities

It seems little progress has been made over the past two decades in bridging the gap between rural and city cancer patients when it comes to treatment.

A study in the Medical Journal of Australia has found cancer patients in rural and remote communities continue to be at increased risk of death from the disease compared to their city counterparts.

The paper looked at cancer deaths from 2001 to 2010.

It found there was no improvement in the rates of regional and remote patients dying of cancer. In fact, for women, the disparity actually increased.

Dr Michael Coorey, from the Murdoch Children's Research Institute, says one of the reasons death rates have not improved is because of the lack of investments in policy on how to organise cancer services so they provide the most benefit to patients.

"Enough is already known about the causes of the regional and remote access in deaths to start evaluating possible solutions," he said.

Possible solutions could include more support for regional and remote patients to travel to metropolitan centres, and more funding for associated accommodation.

Other important programs could include specialist outreach services such as tele-health, fly-in-fly-out services and increasing building capacity in regional cancer centres.

The authors say more investment in health systems and policy research is needed because there is little good evidence to show what will produce improvements in rural cancer care.

In 2010, the federal government announced an investment of $560 million over five years in regional cancer centres.

"Hopefully this will result in significant health gains," the report authors said.

By comparing mortality rates in metropolitan areas to populations in regional and remote areas, the authors found 8,878 excess cancer deaths in remote and regional areas.

The largest numbers were for cancers of the lung, prostate, oesophagus colo-rectal, and melanoma.

Some of the causes of increasing cancer deaths in rural and remote Australia include a higher proportion of Indigenous people and greater economic disadvantage.

Authors say there is also a higher prevalence of cancer risk factors, such as smoking, sun exposure, obesity, less cancer screening, delays in seeking medical attention and disparity in receiving treatment.

Doctors call for more specialist treatment in rural areas

Dr Coorey says research into planning services and budget decisions is not as prestigious as lab and clinical research to identify new diagnostic tests and treatment for cancer.

"However, such research is needed if all of the Australian community is to benefit from laboratory and clinical advances," he said.

Ian Kamerman, the president of the Rural Doctors Association, says the disparity is likely to continue unless more specialist cancer treatment and advice is made available in regional Australia.

"There has been an increase in numbers around the eastern seaboard but as you head further inland people have to travel further and of course the problem is people choose not to have the best cancer treatments when they live in the bush because it takes you away from their home and their family and their carers for a long period of time," he said.

"It is partly their own choices but it is also the choices that are available to them close to home.

"Another issue is the lack of chemotherapy across some of the smaller hospitals. Up-skilling nursing staff and medical staff in small rural hospitals so that they can actually provide chemotherapy services so patients are not travelling long distances."